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Protecting Musculoskeletal Development and Physical Function in Adolescents on GLP-1 Therapy
Webb A Smith1,2, Ahlee Kim3,4, Timothy J Khalil5
1Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, USA.
Childhood Obesity (Print)
|August 3, 2026
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1s) aid pediatric obesity but may impact bone and muscle growth. Combining GLP-1s with exercise and nutrition is crucial for healthy development and long-term outcomes.
Area of Science:
- Pediatric Endocrinology
- Obesity Medicine
- Exercise Physiology
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1s) like semaglutide and liraglutide are effective for pediatric obesity, improving weight and cardiometabolic health.
- GLP-1s can facilitate lifestyle changes by reducing physical and psychosocial barriers in adolescents.
- Concerns exist regarding GLP-1s' impact on musculoskeletal maturation during adolescence, a critical period for bone and muscle mass accrual.
Purpose of the Study:
- To advocate for integrating exercise prescription with GLP-1 therapy in pediatric obesity management.
- To propose a balanced approach addressing potential long-term musculoskeletal effects of GLP-1s in adolescents.
- To emphasize the need for multimodal interventions prioritizing functional health and musculoskeletal integrity.
Main Methods:
- This is a perspective piece, not a clinical trial; it synthesizes existing knowledge and expert opinion.
- Advocates for a multimodal framework combining GLP-1 pharmacotherapy with tailored exercise and nutrition.
- Highlights the importance of resistance training, weight-bearing activities, and adequate protein intake.
Main Results:
- GLP-1s can create an opportunity for initiating sustainable health behaviors.
- Potential attenuation of peak bone and muscle mass accrual necessitates careful management.
- Exercise may synergize with GLP-1s to enhance metabolic and functional outcomes.
Conclusions:
- GLP-1 therapy should be integrated into a comprehensive, multimodal approach for pediatric obesity.
- Emphasis on resistance training, weight-bearing exercise, and adequate protein intake is vital to preserve lean mass and musculoskeletal health.
- Individualized, developmentally appropriate guidance and further longitudinal research are essential for optimizing long-term outcomes in pediatric populations.
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